Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Therapeutics > exam 2 > Flashcards

exam 2 Flashcards

(95 cards)

Start Studying
1
Q

koebner phenomenon

A
  • trauma to an area on skin -> psoriatic patch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

auspitz sign

A
  • if you peel of silvery scaling in psoriasis it will bleed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

nikolsky sign

A
  • press edge of bullae/ vesicle and top epidermal layer separates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

treatment for drug eruptions

A
  • d/c offeding agent
  • antihistamines around the clock
  • topical steroids BID for pruritis
  • PO prednisone if bad
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

SJS and TEN

A
  • TEN covers 30% or more of total body surface area
  • skin comes off in sheets
  • mucosal loss
  • admit to burn unit/ ICU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

common causes of SJS or TEN

A
  • phenytoin
  • carbamazepine
  • piroxicom
  • allopurinol
  • vaccines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

class I steroids

A
  • very potent
  • severe non-facial and non- intertriginous areas
  • scalp, palms, soles, on thick plaques
  • use for < 4 weeks
  • i.e. clobestasol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

class II steroid

A
  • high potency
  • used on non-facial and non-intertriginous areas
  • i.e. mometasone, fluocinonide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

class III-V steroids

A
  • medium potency
  • non-facial and non-intertrignous areas
  • ok on flexor surfaces for short periods
  • can use for < 6-8 weeks
  • i.e. mometasone, triamcinolone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

class VI-VII

A
  • least potent
  • used for larger areas, thinner skin
  • face, eyelids, genitals
  • limit to 1-2 weeks on face and eyelids to avoid atrophy
  • i.e. desonide, hydrocortisone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

steroid absorption

A
  • better absorbed in areas of inflammation and desquamation
  • ointments have higher absorption and potency
  • avoid occlusive dressings d/t atrophy and hypopigmentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how do you dose steroids

A
  • based on rule of 9s
  • size of palm = 1% BSA
  • dose 0.5 grams for 2% of BSA
  • one finger tip= 0.5 grams
  • one 30 gram tube will cover an entire adult body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how should you treat hair and nail fungal infections

A
  • systemic anti-fungals

- dont respond well to topicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the best treatment for candida

A
  • nystatin
  • not absorbed well in GIT
  • candida= yeast normally found on mucous membranes, GIT and skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the best treatment for dermatophytes

A
  • allylamines
  • naftifine
  • terbinafine
  • butenafine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

stage I HTN

A
  • 130-139/ 80-89
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

stage II HTN

A
  • > 140/90
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

lifestyle modifications to treat HTN

A
  • Na restriction to < 1500 mg/day
  • weight loss
  • exercise- 90-150 min a week
  • mod alcohol intake
  • eating K-rich foods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how much impact do lifestyle modifications have on BP?

A
  • each likely to reduce SBP by 3-8 mmHg, DBP by 1-4 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what meds should pts with HTN avoid

A
  • NSAIDs
  • decongestants
  • amphetamines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

thiazide diuretics

A
  • net loss of Na and water in urine
  • after 4-6 weeks of tx Na balance and CO regained but BP remains low
  • decreases TPR because Na causes vascular stiffness
  • average fall in BP on low dose is 10 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how long does HCTZ work

A
  • 24 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

were do thiazide diuretics work

A
  • distal convoluted tubules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ADRs of thiazide diuretics

A
  • hypokalemia -> possible torsades and sudden death
  • hyperglycemia
  • hyperlipidema (stroke risk)
  • hyperuricemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
at what doses are metabolic effects seen for thiazides
- high doses- 50-100 mg/ day | - dont see them at low doses of 12.5-25 mg
26
name the thiazide diuretics
- HCTZ - chlorthalidone - metolazone - indapamide - chlorothiazide
27
name the loop diuretics
- furosemide/lasix - torsemide - bumetanide - ethacrynic acid
28
where do loop diuretics work
- loop of henle/ thick ascending limb
29
what are the classes of k sparing diuretics
- aldosterone antagonists | - Na channel blockers
30
list the aldosterone antagonists
- spironoloactone | - eplerenone
31
list the Na channel blockers
- amiloride | - triamterene
32
where do k sparing diuretics work
- collecting ducts
33
when is renin secreted and from where?
- secreted from kidneys - decreased arterial BP - decreased Na - increased sympathetic activity
34
what does renin act on?
- angitensinogen to convert it to angiotensin I
35
how do you get angiotensin II?
- angtiotensin I converted to angiotensin II via ACE
36
main role of angiotensin II
- powerful vasoconstrictor - causes aldosterone release -> Na retention - mainly concerned about the ATI receptor
37
other effects of angiotensin II
- vasoconstriction of renal arterioles -> glomerular damage - decreased NO release - decreased fibrinolysis in blood - increased thirst - mitogenic effect- cell proliferation
38
overall "bad" effect of angiotensin II
- volume overload and increased TPR - cardiac hypertrophy/ remodeling HTN - myocardial infarction - renal damage - CV morbidity and mortality
39
benefits of ACEI
- reverse cardiac and vascular hypertrophy - no postural hypotension or electrolyte abnormalities - safe in asthmatics and diabetics - reverse ventricular hypertrophy - increase lumen size - no rebound HTN - no hyperuricemia, lipid impact - renal perfusion maintained - prevent secondary hyperaldosteronism and K loss
40
indications for ACEI
- HTN - CHF - MI - prophylaxis of high CV risk pts - diabetic nephropathy - scleroderma crisis
41
side effects of ACEI
- cough d/t bradykinin inhibition - angioedema - hyperkalemia- in renal failure, k sparing diuretics, NSAIDs - AKI
42
contraindications for ACEI
- pregnancy - bilat renal artery stenosis - hypersensitivity - hyperkalemia
43
ARBs
- specific to AT1 receptors - less incidence of cough - get vasodilation
44
CCB
- cause SMC relaxation and vasodilation - non-DHPs good for rate control - no metabolic effects - no sedation - can be given in asthma, angina, and PVD - no renal or male sexual dysfunction
45
contraindications for CCB
- unstable angina - HF - hypotension - post infarct - severe aortic stenosis
46
list some nonselective BB
- propranolol - nadolol - timolol - pindolol - labetolol
47
list some selective BB
- metoprolol - atenolol - esmolol - betaxolol
48
effect of BB
- both classes have similar anti-HTN effect - reduce CO and BP slowly - reduce Na release - central sympathetic outflow reduction - nonselective BB reduce GFR
49
advantages of BB
- no postural hypotension - no Na and water retention - low incidence ADRs - low cost, dosed once a day - pref in young non-obese pts - prevent sudden cardiac death in post MI pts and progressive CHF*
50
patients you should consider cardio-selective BB in
- young non-obese HTN - angina pectoris and post angina pts - post MI pts - carvedilol in elderly- vasodilatory effect
51
ADRs of BB
- fatigue, lethargy, decreased work capacity - loss of libido/ impotence - forgetfulness - bradycardia - bronchospasm - c/i in insulin dependent diabetics - increased TG, decreased HDL
52
what drugs should not be combined with BB
- CCB | - NSAIDs blunt BB effect
53
alpha adrenergic blockers
- not used in chronic essential HTN - may be used for pheochromocytoma - really only used for BPH - can be adjunct when pts failing diuretics or BB
54
ADRs of alpha adrenergics
- postural hypotension - fluid retention when used as monotx- avoid in CHF - HA - dry mouth - weakness - blurred vision - rash - drowsiness - failure to ejaculate
55
hydralazine MOA
- direct acting vasodilator | - liberates NO and decreases TPR
56
hydralazine indications
- NOT as monotx | - only in severe or refractory HTN
57
ADRs of hydralazine
- rebound tachycardia - hypotension - fluid retention - lupus like syndrome
58
mechanism sodium nitroprusside
- RBCs convert nitroprusside to NO - direct acting vasodilator - rapid acting - reduces TPR and CO
59
nitroprusside indications
- HTN emergency | - improves ventricular fn in HF by reducing preload
60
ADRs of nitroprusside
- palpitations - abdominal pain - disorentation - psychosis - weakness - lactic acidosis - d/t release of cyanides
61
methyldopa
- centrally acting - prodrug - used for HTN in pregnancy
62
ADRs of methyldopa
- cognitive impairment - postural hypotension - pos coombs test
63
HTN and CKD
- ACEI and ARB preferred | - CKD- abnormal kidney structure and fn present for > 3 mo, usually classified based on albuminuria > 30
64
HTN and elderly
- favorable data for low dose thiazides - some data for DHP, CCB, ACEI - consider fall risk and hypoperfusion - tight BP regulation -> decreased blood to brain -> syncope
65
HTN and blacks
- thiazides and CCB preferred for monotx - have low plasma renin activity - increased Na/fluid loading - very responsive to thaizides
66
diabetes and HTN
- no role in deciding initial tx - ACE/ARB should be part of regimen, esp first line if albuminuria - prefered to reduce/ prevent nephropathy
67
resistant HTN
- BP above goal despite use of 3+ meds - usually diuretic + ACEI/ARB + CCB - must r/o secondary causes before you dx someone with resistant HTN
68
risk factors for resistant HTN
- age, female - high BP at baseline - obesity - salt intake - CKD - DM - LVH - AA
69
secondary causes for HTN
- obstructive sleep apnea - primary aldosteronism - advanced CKD or renal artery stenosis - volume overload - excessive alcohol intake - obesity - meds
70
meds to check if pt is using before dx of resistant HTN
- NSAIDs, COX2 - vasoconstrictors - stimulants, cocaine, illicit drugs - decongestants - diet pills - OCP - steroids, cyclosporine, tacrolimus - erythrpoietin
71
meds to treat resistant HTN
- k sparing diuretics- spironolactone best - BB- can consider if HR > 80 bpm, usually carvedilol or labetolol - alpha 1 blockers if low HR and/or BPH
72
PO drugs that cover MRSA
- bactrim - clindamycin - tetracyclines - linezolid
73
IV drugs that cover MRSA
- vanco - daptomycin - linezolid - tigecycline - telavancin - ceftaroline
74
drugs that cover pseudomonas
- zosyn - cetazidime - cefepime - fluoroquinolines (only PO option from list) - aztreonam
75
treatment for MSSA infections
- dicloxacillin PO - nafcillin or oxacillin IV - cefazolin, cephalexin, cefadroxil - bactrim
76
treatment for otitis media
- amoxicillin first line - augmentin ES if recurrent or severe - ofloxacin drops- tubes or perf - bactrim, axithromycin or clinda if PCN allergy - IM ceftriaxone one dose of pt is throwing up
77
risk factors for otitis media
- parents who smoke - not breast fed - sleeping with bottle - not vaccinated
78
treatment for lyme disease
- doxycycline first line- 100 mg BID X 21 days | - amoxicillin or cefuroxime as alt for pregnancy or kids
79
abx to avoid in pregnancy
- bactrim - fluoroquinolones - tetracyclines
80
abx to avoid in kids
- tetracyclines - fluoroquinolones - consider child if med is administered to breast feeding mother
81
fluoroquinolone ADRs
- BBW tendinopathies - hypo/hyperglycemia - delirium in elderly - QTc prolongation - decreased seizure threshold - c/i in kids and pregnancy
82
which drugs have seizure risk
- all beta lactams if not dosed based on renal function - highst- cefepime, carbapenems - fluoroquinolones
83
treatment for throat infections
- PCN | - macrolide of PCN allergy
84
most common cause of throat infections
- strep pyogenes
85
most common cause of otitis media
- s pneumoniae - f flu - m catarrhalis
86
when do you use MRI for ortho
- soft tissue eval - occult fx eval - need xray first
87
when do you use CT for ortho
- obvious fx seen on xray -> surgical planning | - assess articular surface
88
when do you use US for ortho
- injection guidance | - superficial tissue eval
89
treatment for stable fx
- splint - crutches/ sling - RICE - pain meds - refer to ortho
90
treatment for unstable fx
- splint - pain meds - consult ortho - further imaging? - surgery?
91
treatment for sprain
- splint/ boot - sling/ crutches - RICE - NSAIDs/ tylenol
92
treatment for tendinosis/ tendinopathy
- splint/ sling - RICE - NSAIDs/ tylenol - PT - refer to ortho
93
treatment for dislocation
- get xrays - pain meds - reduce joint - crutches/ sling - RICE - refer to ortho
94
treatment for disc herniation +/- radiculopathy
- steroid taper - pain meds? - MRI? - refer to ortho
95
treatment for metastatic lesions
- further imaging like MRI or bone scan? - consult ortho - ORIF/ IM rodding/ hemiarthroplasty? - pain meds?

Therapeutics (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions